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Prevalence of Renal Insufficiency in Individuals with Hypertension and Obesity/Overweight: The FATH Study

Pablo Gomez^*, Luis Miguel Ruilope, Vivencio Barrios, Jorge Navarro, Miguel Angel Prieto^||, Olga Gonzalez^¶, Lucía Guerrero, Miguel Angel Sanchez Zamorano, Claudia Filozof on behalf of the FATH Study Group

^* Nephrology Department, Hospital del SAS, Jeréz de la Frontera, Hypertension Unit and ^¶ Endocrinology Unit, Hospital 12 de Octubre, and Cardiology Department, Hospital Ramón y Cajal, Madrid, Salvador Pau, Health Center, Valencia, ^|| Vallobin Concinos Health Center, Oviedo, and Scientific Department, Bristol-Myers Squibb, Madrid, Spain

Address correspondence to: Dr. Pablo Gomez, Nephrology Department, Hospital del SAS, Jerez de la Frontera, Spain (11407). Phone/Fax: +34-956-032556; E-mail: pgomezf{at}senefro.org

Overweight and obesity are associated with increased cardiovascular risk. Some studies have demonstrated that they also can result in renal damage. The aim of this study was to assess the prevalence of renal insufficiency (RI), defined as a GFR <60 ml/min per 1.73 m², in a cohort of 4585 patients who attended primary care with essential hypertension and a body mass index 25 kg/m². The patients were classified as overweight and obese according to body mass index (25 to 29.9 and 30 kg/m², respectively). Abdominal obesity was defined as a waist circumference 88 and 102 cm in women and men, respectively. Both groups had a high prevalence of metabolic syndrome (Adult Treatment Panel III). The prevalence of RI was high in both the overweight group (22.7%; 95% confidence interval [CI] 20.6 to 24.9) and in the obese group (22.8%; 95% CI 21.0 to 24.7). The presence of diabetes increased the risk for RI (odds ratio 1.83; 95% CI 1.55 to 2.16). The prevalence of RI was greater in patients with abdominal obesity (23 versus 17%; P < 0.001). In the presence of abdominal obesity, cardiovascular risk factors and components of the metabolic syndrome also were more prevalent. The higher risk for RI with abdominal obesity persisted even after adjustment for dyslipidemia, elevated blood glucose levels, and other variables that are associated with RI (adjusted odds ratio 1.40; 95% CI 0.84 to 2.33). It was concluded that patients who have hypertension and visceral obesity and attend primary care present a higher prevalence of metabolic syndrome and RI.

Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673